Construction of a risk prediction model of mild cognitive impairment in hospitalized patients with hypertension

Li WANG; Lian ZHOU; Yanni YANG

doi:10.16016/j.2097-0927.202111189

您当前的位置：

首页 >

文章列表页 >

Construction of a risk prediction model of mild cognitive impairment in hospitalized patients with hypertension

更新时间：2026-01-09

- Construction of a risk prediction model of mild cognitive impairment in hospitalized patients with hypertension
- Journal of Army Medical University Vol. 44, Issue 8, Pages: 835-841(2022)
- 作者机构：
  
  1.400038 重庆，陆军军医大学(第三军医大学)：护理系
  2.400038 重庆，陆军军医大学(第三军医大学)：第一附属医院心血管内科
- 作者简介：
- 基金信息：
- DOI：10.16016/j.2097-0927.202111189
  CLC： R181.32;R544.1;R749.16
- Received：26 November 2021，
  
  Revised：2021-12-22，
  
  Published：30 April 2022
- 稿件说明：
移动端阅览
Li WANG, Lian ZHOU, Yanni YANG. Construction of a risk prediction model of mild cognitive impairment in hospitalized patients with hypertension[J]. Journal of Army Medical University, 2022, 44(8): 835-841.
DOI：

Li WANG, Lian ZHOU, Yanni YANG. Construction of a risk prediction model of mild cognitive impairment in hospitalized patients with hypertension[J]. Journal of Army Medical University, 2022, 44(8): 835-841. DOI： 10.16016/j.2097-0927.202111189.

摘要

目的

探索住院高血压患者伴发轻度认知功能障碍的危险因素，并建立风险预测列线图模型。

方法

选取2021年5-11月于本院心血管内科住院的182例高血压患者，采用个人基本信息问卷、简明精神状态量表、北京版蒙特利尔认知评估量表、应对适应量表、抑郁自评量表、高血压治疗依从性量表进行调查。采用Logistic回归逐步法筛选发生轻度认知功能障碍的独立危险因素，并建立风险预测列线图模型。

结果

住院高血压患者伴发轻度认知功能障碍的患病率为68.1%。基于Logistic回归分析，最终纳入年龄(

=1.053)、糖尿病(

=2.359)、日常生活管理行为(

=0.926)、受教育年限(

=0.776)、应对适应能力(

=0.947)5个危险因素构建出风险预测模型。Calibration校正曲线提示模型准确度良好，ROC曲线下面积为0.844(95%

0.783~0.893)，提示模型具有良好的区分度。

结论

基于住院高血压患者伴发轻度认知功能障碍的危险因素构建的风险预测模型一致性和预测效能较好。

Abstract

Objective

To explore the risk factors of mild cognitive impairment in hospitalized patients with hypertension

and establish a risk prediction nomogram model.

Methods

A total of 182 patients with hypertension admitted in our hospital from May to November 2021 were enrolled in this study. They were surveyed with information questionnaire

Mini-Mental State Examination

Beijing version of Montreal Cognitive Assessment

Coping and Adaptation Processing Scale

Self-Rating Depression Scale and Therapeutic Adherence Scale. Logistic regression stepwise analysis was used to screen the independent risk factors of mild cognitive impairment

and the risk prediction nomogram model was established.

Results

The prevalence rate of mild cognitive impairment in hospitalized hypertensive patients was 68.1%. Based on the results of logistic regression analysis

5 risk factors including a

ge (

=1.053)

diabetes (

=2.359)

daily life management (

=0.926)

years of education (

=0.776)

and coping and adaptation (

=0.947) were finally included to construct a risk prediction model. The calibration curve indicated that the model possessed good accuracy. The area under the curve was 0.844 (95%

: 0.783~0.893)

indicating that the model possessed good discrimination.

Conclusion

Based on the risk factors of mild cognitive impairment in hospitalized hypertensive patients

our established risk prediction model has good consistency and prediction efficiency.

关键词

Keywords

references

IADECOLA C, YAFFE K, BILLER J, et al . Impact of hypertension on cognitive function: a scientific statement from the American Heart Association[J ] . Hypertension, 2016, 68(6): e67-e94. DOI: 10.1161/HYP.0000000000000053.

LIVINGSTON G, HUNTLEY J, SOMMERLAD A, et al . Dementia prevention, intervention, and care: 2020 report of the lancet commission[J ] . Lancet, 2020, 396(10248): 413-446. DOI: 10.1016/S0140-6736(20)30367-6.

WARD A, TARDIFF S, DYE C, et al . Rate of conversion from prodromal Alzheimer's disease to Alzheimer's dementia: a systematic review of the literature[J ] . Dement Geriatr Cogn Dis Extra, 2013, 3(1): 320-332. DOI: 10.1159/000354370.

陈代敏, 张佳, 吕洋. 认知障碍风险预测模型的研究进展[J]. 内科理论与实践, 2020, 15(3): 184-188. DOI: 10.16138/j.1673-6087.2020.03.010.

CHEN D M, ZHANG J, LYU Y. Update on the research of prediction model in cognitive impairment[J]. J Intern Med Concepts Pract, 2020, 15(3): 184-188. DOI: 10.16138/j.1673-6087.2020.03.010.

中国高血压防治指南修订委员会, 高血压联盟(中国), 中华医学会心血管病学分会, 等. 中国高血压防治指南(2018年修订版)[J]. 中国心血管杂志, 2019, 24 (1): 24-56. DOI: 10.3969/j.issn.1007-5410.2019.01.002.

Writing Group of 2018 Chinese Guidelines for the Management of Hypertension, Chinese Hypertension League, Chinese Society of Cardiology, et al. 2018 Chinese guidelines for the management of hypertension[J]. Chin J Cardiovasc Med, 2019, 24(1): 24-56. DOI: 10.3969/j.issn.1007-5410.2019.01.002.

孙振球, 徐勇勇. 医学统计学[M]. 5版. 北京: 人民卫生出版社, 2020: 507-508.

SUN Z Q, XU Y Y. Medical statistics[M]. 5th ed. Beijing: People's Medical Publishing House, 2020: 507-508.

WANG Y M, SONG M, YU L L, et al . Mild cognitive impairment: vascular risk factors in community elderly in four cities of Hebei Province, China[J ] . PLoS One, 2015, 10(5): e0124566. DOI: 10.1371/journal.pone.0124566.

PETERSEN R C, MORRIS J C. Mild cognitive impairment as a clinical entity and treatment target[J]. Arch Neurol, 2005, 62(7): 1160-1163. DOI: 10.1001/archneur.62.7.1160.

李格, 沈漁邨, 陈昌惠, 等. 老年痴呆简易测试方法研究: MMSE在城市老年居民中的测试[J]. 中国心理卫生杂志, 1988, 2(1): 13-18.

LI G, SHEN Y C, CHEN C H, et al . Preliminary appl ication of MMSE in the aged of urban population in Beijing[J ] . Chin Ment Heal J, 1988, 2(1): 13-18.

郭起浩. 神经心理评估[M]. 3版. 上海: 上海科学技术出版社, 2020: 87-94.

GUO Q H. Neuropsychological assessment[M]. 3th ed. Shanghai: Shanghai Science and Technology Press, 2020: 87-94.

李世杰, 杨燕妮, 黄丽, 等. 中文版简易罗伊应对适应量表的信度效度研究[J]. 中国护理管理, 2018, 18(6): 766-770. DOI: 10.3969/j.issn.1672-1756.2018.06.010.

LI S J, YANG Y N, HUANG L, et al . Reliability and validity of the Chinese version of the short form Coping and Adaption Processing Scale on Roy Model[J ] . Chin Nurs Manag, 2018, 18(6): 766-770. DOI: 10.3969/j.issn.1672-1756.2018.06.010.

ROY C, BAKAN G, LI Z S, et al . Coping measurement: creating short form of Coping and Adaptation Processing Scale using item response theory and patients dealing with chronic and acute health conditions[J ] . Appl Nurs Res, 2016, 32: 73-79. DOI: 10.1016/j.apnr.2016.06.002.

唐红英. 高血压治疗依从性量表和态度与信念量表的编制及重庆市常模的建立[D]. 重庆: 第三军医大学, 2011.

TANG H Y. Development of a new therapeutic adherence scale and an antihypertensive therapy related attitudes and beliefs scale for hypertensive patients and establishment of the norm of the scales in Chongqing[D]. Chongqing: Third Military Medical University, 2011.

ZUNG W W. A self-rating depression scale[J]. Arch Gen Psychiatry, 1965, 12: 63-70. DOI: 10.1001/archpsyc.1965.01720310065008.

中国肥胖问题工作组. 中国成人超重与肥胖症预防与控制指南(节录)[J]. 营养学报, 2004, 26(1): 1-4. DOI: 10.3321/j.issn: 0512-7955.2004.01.001.

China Obesity Working Group. Guidelines for prevention and control of overweight and obesity in Chinese adults[J]. Acta Nutr Sin, 2004, 26(1): 1-4. DOI: 10.3321/j.issn: 0512-7955.2004.01.001.

KUŹMA E, LOURIDA I, MOORE S F, et al . Stroke and dementia risk: a systematic review and meta-analysis[J ] . Alzheimers Dement, 2018, 14(11): 1416-1426. DOI: 10.1016/j.jalz.2018.06.3061.

HARADA C N, NATELSON LOVE M C, TRIEBEL K L. Normal cognitive aging[J]. Clin Geriatr Med, 2013, 29(4): 737-752. DOI: 10.1016/j.cger.2013.07.002.

薛嫱, 宋丽清, 田巍, 等. 高龄高血压患者血压变异性与认知功能损害[J]. 中华老年多器官疾病杂志, 2018, 17(6): 407-411. DOI: 10.11915/j.issn.1671-5403.2018.06.091.

XUE Q, SONG L Q, TIAN W, et al . Blood pressure variability and cognitive impairment in very elderly hypertensive patients[J ] . Chin J Mult Organ Dis Elder, 2018, 17(6): 407-411. DOI: 10.11915/j.issn.1671-5403.2018.06.091.

THOW M E, SUMMERS M J, SAUNDERS N L, et al . Further education improves cognitive reserve and triggers improvement in selective cognitive functions in older adults: the Tasmanian Healthy Brain Project[J ] . Alzheimers Dement (Amst), 2018, 10: 22-30. DOI: 10.1016/j.dadm.2017.08.004.

甘旭光. 社区老年人常见慢性病及其共病与轻度认知功能障碍的关联性研究[D]. 武汉: 武汉科技大学, 2021.

GAN X G. Association of chronic diseases and comorbidities with mild cognitive impairment in community older adults[D]. Wuhan: Wuhan University of Science and Technology, 2021.

TCHISTIAKOVA E, ANDERSON N D, GREENWOOD C E, et al . Combined effects of type 2 diabetes and hypertension associated with cortical thinning and impaired cerebrovascular reactivity relative to hypertension alone in older adults[J ] . Neuroimage Clin, 2014, 5: 36-41. DOI: 10.1016/j.nicl.2014.05.020.

DAUGHERTY A M. Hypertension-related riskfor dementia: a summary review with future directions[J]. Semin Cell Dev Biol, 2021, 116: 82-89. DOI: 10.1016/j.semcdb.2021.03.002.

NGANDU T, LEHTISALO J, SOLOMON A, et al . A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial[J ] . Lancet, 2015, 385(9984): 2255-2263. DOI: 10.1016/S0140-6736(15)60461-5.

KO Y, CHYE S M. Lifestyle intervention to prevent Alzheimer's disease[J]. Rev Neurosci, 2020, 31(8): 817-824. DOI: 10.1515/revneuro-2020-0072.

CASAGRANDE M, BONCOMPAGNI I, MINGARELLI A, et al . Coping styles in individuals with hypertension of varying severity[J ] . Stress Health, 2019, 35(4): 560-568. DOI: 10.1002/smi.2889.

SVENSSON T, INOUE M, SAWADA N, et al . Coping strategies and risk of cardiovascular disease incidence and mortality: the Japan Public Health Center-based prospective Study[J ] . Eur Heart J, 2016, 37(11): 890-899. DOI: 10.1093/eurheartj/ehv724.

FRENZEL S, WITTFELD K, BVLOW R, et al . Cardiac hypertrophy is associated with advanced brain aging in the general population[J ] . J Am Heart Assoc, 2021, 10(17): e020994. DOI: 10.1161/JA HA.121.020994.

HARING B, OMIDPANAH A, SUCHY-DICEY A M, et al . Left ventricular mass, brain magnetic resonance imaging, and cognitive performance: results from the strong heart study[J ] . Hypertension, 2017, 70(5): 964-971. DOI: 10.1161/HYPERTENSIONAHA.117.09807.

Views

下载量

CSCD

Alert me when the article has been cited

提交

Tools

Publicity Resources

Development and validation of a prediction model for amputation risk in patients with diabetic foot ulcers based on systematic review and meta-analysis

Predictive nomogram for central lymph node metastasis in papillary thyroid microcarcinoma based on CT-clinical data

Risk factors for postoperative respiratory failure in patients undergoing cardiovascular surgery and construction of a prediction model

Construction and validation of prediction model for cervical cancer recurrence based on systemic inflammation response index and clinicopathological parameters

Related Author

WU Ju

LIU Guangyang

MING Tianjiao

WU Yazhou

LI Fang

HAN Weidong

FAN Yiming

CHEN Pan

Related Institution

School of International Economics and Trade, University of International Business and Economics

Brigade of Non-Military Students， College of Basic Medical Sciences， Army Medical University （Third Military Medical University）， Chongqing, University of International Business and Economics

Department of Health Statistics， College of Military Preventive Medicine, University of International Business and Economics

Department of Dermatology， First Affiliated Hospital， Army Medical University （Third Military Medical University）

Department of Radiology, the Second Affiliated Hospital of Chongqing Medical University

⁰